Glutamic Acid Decarboxylase Autoimmunity With Brainstem, Extrapyramidal, and Spinal Cord Dysfunction

The neurological spectrum of GAD65 autoimmunity includes brainstem, extrapyramidal, and spinal cord syndromes. In our experience, African American patients were disproportionately affected. A patient with a presumed neurodegenerative disorder of new onset, with high levels of GAD65 antibody (>20 nmol/L), merits consideration of immunotherapy.